: Billing Rule Result Reason - JSON Representation
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{
"resourceType" : "CodeSystem",
"id" : "billing-rule-reason",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem billing-rule-reason</b></p><a name=\"billing-rule-reason\"> </a><a name=\"hcbilling-rule-reason\"> </a><p>This case-sensitive code system <code>https://fhir.cognovis.de/praxis/CodeSystem/billing-rule-reason</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">RULES_UNAVAILABLE<a name=\"billing-rule-reason-RULES_UNAVAILABLE\"> </a></td><td>Rules unavailable</td><td>No readable rule corpus is available for the applicable catalog scope.</td></tr><tr><td style=\"white-space:nowrap\">RULESET_STALE<a name=\"billing-rule-reason-RULESET_STALE\"> </a></td><td>Ruleset stale</td><td>The available ruleset is outside its accepted freshness or effective-period contract.</td></tr><tr><td style=\"white-space:nowrap\">RULESET_PARTIAL<a name=\"billing-rule-reason-RULESET_PARTIAL\"> </a></td><td>Ruleset partial</td><td>The available ruleset declares partial structured coverage.</td></tr><tr><td style=\"white-space:nowrap\">RULESET_UNSUPPORTED<a name=\"billing-rule-reason-RULESET_UNSUPPORTED\"> </a></td><td>Ruleset unsupported</td><td>The ruleset schema or semantic version is unsupported.</td></tr><tr><td style=\"white-space:nowrap\">RULE_CLASS_UNSUPPORTED<a name=\"billing-rule-reason-RULE_CLASS_UNSUPPORTED\"> </a></td><td>Rule class unsupported</td><td>The evaluator does not support the declared rule class semantic major.</td></tr><tr><td style=\"white-space:nowrap\">RULE_PARAMETER_UNSUPPORTED<a name=\"billing-rule-reason-RULE_PARAMETER_UNSUPPORTED\"> </a></td><td>Rule parameter unsupported</td><td>The evaluator does not support a declared must-understand parameter.</td></tr><tr><td style=\"white-space:nowrap\">SOURCE_COVERAGE_INCOMPLETE<a name=\"billing-rule-reason-SOURCE_COVERAGE_INCOMPLETE\"> </a></td><td>Source coverage incomplete</td><td>The source manifest declares a must-understand structured or prose coverage gap.</td></tr><tr><td style=\"white-space:nowrap\">SERVICE_DATE_UNRESOLVED<a name=\"billing-rule-reason-SERVICE_DATE_UNRESOLVED\"> </a></td><td>Service date unresolved</td><td>No unambiguous ruleset version can be resolved for the service date.</td></tr><tr><td style=\"white-space:nowrap\">REQUIRED_FACT_NOT_SUPPLIED<a name=\"billing-rule-reason-REQUIRED_FACT_NOT_SUPPLIED\"> </a></td><td>Required fact not supplied</td><td>The caller did not supply a fact required by the rule.</td></tr><tr><td style=\"white-space:nowrap\">REQUIRED_FACT_SOURCE_UNAVAILABLE<a name=\"billing-rule-reason-REQUIRED_FACT_SOURCE_UNAVAILABLE\"> </a></td><td>Required fact source unavailable</td><td>The source needed to determine a required fact is unavailable.</td></tr><tr><td style=\"white-space:nowrap\">RULE_VIOLATION<a name=\"billing-rule-reason-RULE_VIOLATION\"> </a></td><td>Rule violation</td><td>The evaluated facts violate the declared rule.</td></tr><tr><td style=\"white-space:nowrap\">RULE_REQUIREMENT_UNMET<a name=\"billing-rule-reason-RULE_REQUIREMENT_UNMET\"> </a></td><td>Rule requirement unmet</td><td>A declared approval, agreement, companion, documentation, or other requirement is unmet.</td></tr><tr><td style=\"white-space:nowrap\">RULE_ADVISORY<a name=\"billing-rule-reason-RULE_ADVISORY\"> </a></td><td>Rule advisory</td><td>The rule produced a non-blocking advisory result.</td></tr></table></div>"
},
"url" : "https://fhir.cognovis.de/praxis/CodeSystem/billing-rule-reason",
"identifier" : [
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.3.7985.16.22"
}
],
"version" : "1",
"name" : "BillingRuleReasonCS",
"title" : "Billing Rule Result Reason",
"status" : "active",
"experimental" : false,
"date" : "2026-08-22T18:18:46+02:00",
"publisher" : "cognovis GmbH",
"contact" : [
{
"name" : "cognovis GmbH",
"telecom" : [
{
"system" : "url",
"value" : "https://www.cognovis.de"
},
{
"system" : "email",
"value" : "info@cognovis.de"
}
]
}
],
"description" : "Stable machine-readable reasons for source-neutral billing-rule outcomes.",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "DE"
}
]
}
],
"copyright" : "Copyright 2026+ cognovis GmbH. Cognovis-authored material is licensed under Apache-2.0; third-party material retains its own terms as documented in THIRD_PARTY_NOTICES.md.",
"caseSensitive" : true,
"content" : "complete",
"count" : 13,
"concept" : [
{
"code" : "RULES_UNAVAILABLE",
"display" : "Rules unavailable",
"definition" : "No readable rule corpus is available for the applicable catalog scope."
},
{
"code" : "RULESET_STALE",
"display" : "Ruleset stale",
"definition" : "The available ruleset is outside its accepted freshness or effective-period contract."
},
{
"code" : "RULESET_PARTIAL",
"display" : "Ruleset partial",
"definition" : "The available ruleset declares partial structured coverage."
},
{
"code" : "RULESET_UNSUPPORTED",
"display" : "Ruleset unsupported",
"definition" : "The ruleset schema or semantic version is unsupported."
},
{
"code" : "RULE_CLASS_UNSUPPORTED",
"display" : "Rule class unsupported",
"definition" : "The evaluator does not support the declared rule class semantic major."
},
{
"code" : "RULE_PARAMETER_UNSUPPORTED",
"display" : "Rule parameter unsupported",
"definition" : "The evaluator does not support a declared must-understand parameter."
},
{
"code" : "SOURCE_COVERAGE_INCOMPLETE",
"display" : "Source coverage incomplete",
"definition" : "The source manifest declares a must-understand structured or prose coverage gap."
},
{
"code" : "SERVICE_DATE_UNRESOLVED",
"display" : "Service date unresolved",
"definition" : "No unambiguous ruleset version can be resolved for the service date."
},
{
"code" : "REQUIRED_FACT_NOT_SUPPLIED",
"display" : "Required fact not supplied",
"definition" : "The caller did not supply a fact required by the rule."
},
{
"code" : "REQUIRED_FACT_SOURCE_UNAVAILABLE",
"display" : "Required fact source unavailable",
"definition" : "The source needed to determine a required fact is unavailable."
},
{
"code" : "RULE_VIOLATION",
"display" : "Rule violation",
"definition" : "The evaluated facts violate the declared rule."
},
{
"code" : "RULE_REQUIREMENT_UNMET",
"display" : "Rule requirement unmet",
"definition" : "A declared approval, agreement, companion, documentation, or other requirement is unmet."
},
{
"code" : "RULE_ADVISORY",
"display" : "Rule advisory",
"definition" : "The rule produced a non-blocking advisory result."
}
]
}
